Under complete aseptic conditions, fluoroscopic guided needle insertion in the glenohumeral joint was performed, after the procedure patient did not show any discomfort except mild feeling of joint distension which encouraged us to stop joint injection at 14 cc of contrast volume.
The second image shows the ideal position of the spinal needle direction during the anterior shoulder injection where the needle hub and stylet should be on the same X-ray beam axis and more near the humeral cortical head at the junction between the upper third and lower two-third of the glenohumeral joint.
The last image shows the flow of contrast mixture into the subcoracoid bursa (normally connected to shoulder joint space).
After fluoroscopic guided needle insertion into the right glenohumeral joint, contrast flow passed into the subcoracoid bursa and glenohumeral joint space. No contrast leakage into the sub-acromial or sub-deltoid bursae could be seen, also no leakage along the needle tract was seen after needle withdrawal.
NB: Before needle insertion arm position was adjusted, the humerus was overriding the glenoid cavity. We applied some axial traction to place it again into its anatomical position.